What is the best mode of growth hormone administration?
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Adolescent↗
Biomedical subjects
T Tuvemo
Publications and source records attributed to T Tuvemo.
Prevalence of IDDM in schoolchildren in Khartoum, Sudan.
The prevalence of insulin-dependent diabetes mellitus (IDDM) in 42,981 schoolchildren (aged 7-14 yr) in Khartoum, Sudan, was determined. With the 1985 World Health Organization revised criteria for diagnosis and classification of diabetes mellitus, the overall crude prevalence rate of IDDM was 0.95/1000 in the age groups studied. This figure is thought to reflect the minimum prevalence of IDDM in that population, because there is an inherent tendency in the method of screening used toward underestimating the true prevalence rate. The prevalence of IDDM was found to increase significantly with age and was slightly higher in girls than boys, but this was not statistically significant. Of 41 children with IDDM detected in the survey, 7 were not known to have IDDM before but were showing suggestive symptoms at the time of the study. This study showed that IDDM in childhood is not rare in Sudan and that probably a substantial number of undiagnosed cases exist.
Age Factors↗
Serum lipids and apolipoproteins in children with type 1 (insulin-dependent) diabetes during the first two years of the disease.
Serum lipoproteins and apolipoproteins were studied at diagnosis and 6, 12 and 24 months later in 30 consecutive children aged 3-15 years with newly detected Type 1 (insulin-dependent) diabetes mellitus (December 1982-October 1984) and in 44 healthy control children. Serum triglycerides at diagnosis were significantly higher than after 6-24 months and also higher than in the control group (p less than 0.001). At follow-up, triglycerides in the very low density lipoproteins and low density lipoproteins were restored to normal, while high density lipoprotein triglycerides remained high. Serum cholesterol at onset of diabetes was significantly higher than in the control children (p less than 0.01), mainly because of increased very low density lipoprotein cholesterol (p less than 0.001). Cholesterol in serum and in the serum lipoprotein fractions was similar to that in the control children at follow-up, except that high density lipoprotein cholesterol was higher in the diabetic children after 6 months. The concentrations of the serum apolipoproteins A-I, A-II and B were higher at onset of diabetes than in the control children (p less than 0.001, p less than 0.01, p less than 0.05 respectively), with a significantly increased ratio of apolipoprotein A-I to A-II in the diabetic children (p less than 0.001). The serum apolipoprotein concentrations were normalised during treatment. The ratio of apolipoprotein A-I to B did not differ from that in control children. On admission, there were strong positive correlations between HbA1c and the concentrations of the very low density lipoproteins and the low density and high density lipoprotein triglycerides.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Circulating class II transplantation antigen-expressing T lymphocytes in children with insulin-dependent diabetes mellitus at diagnosis.
The occurrence of circulating class II antigen-expressing T lymphocytes was examined in 25 children with insulin-dependent diabetes mellitus using an indirect double immunofluorescence assay on prefixed cell samples. In order to exclude sensitization to heterologous insulin as a possible factor affecting the results, the patients were investigated at the day of clinical onset, before receiving insulin. An increased percentage of T cells (CD3+ cells) expressing class II antigens was seen in 19 out of 25 patients and class II expression was observed on cells within both the CD4+ and CD8+ T cell subsets. No correlation was found between the levels of class II expressing T cells and the individual degree of metabolic derangement or indicators of recent infection. Re-testing of 16 patients after one year on insulin treatment revealed a significant decrease of class II expressing T cell levels. Our data suggest that the increased levels of class II expressing T cells seen in IDDM of recent onset directly reflects immune reactions that are related to the disease process.
Adolescent↗
Early changes of some serum proteins and metals in diabetic children.
Serum concentrations of prealbumin, albumin, orosomucoid, magnesium, zinc and calcium were studied in 30 children with newly diagnosed IDDM aged 3-15 years, during the first two years of the disease, and in 44 healthy control children. On admission serum prealbumin was significantly lower in IDDM children (149 +/- 48 mg/l) (M +/- SD) than in healthy controls (194 +/- 39 mg/l) (p less than 0.001). During the two years follow-up prealbumin increased significantly, but did not reach the level of healthy controls. Serum albumin was slightly increased at diagnosis (p less than 0.01), but later decreased significantly (p less than 0.01). Orosomucoid concentrations did not differ between diabetics and controls. Serum magnesium was initially within the reference interval but later decreased, and after 2 years of IDDM it was highly significantly reduced (p less than 0.001). Serum zinc was significantly reduced in IDDM children at diagnosis (p less than 0.001), but was within the reference interval after one and 2 years. Serum calcium was increased in the IDDM group at diagnosis (p less than 0.01), but later normalized. It is concluded that in early IDDM there is a decrease in serum prealbumin and albumin, and serum magnesium decreases progressively, while serum zinc is only transiently reduced.
Adolescent↗
Serum selenium is related to low-density lipoproteins in healthy children but not in children with diabetes.
The serum concentrations of selenium in 13 healthy children and 27 children with type 1 diabetes mellitus were evaluated in relation to serum lipoprotein and apolipoprotein concentrations. In healthy children a correlation was found between serum selenium and both serum cholesterol (r = 0.56; p less than 0.05) and serum triglycerides (r = 0.56; less than 0.05) and their low-density lipoprotein (LDL) + very low-density lipoprotein (VLDL) fractions (r = 0.60 and 0.56 respectively; p less than 0.05), but not their high-density lipoprotein fractions. Associations were also found between selenium and apolipoproteins, especially A II and C II (r = 0.57; p less than 0.05). In diabetic children serum selenium was significantly correlated with apolipoproteins A II and Apo C II, but not with any lipoprotein or lipid or any of their fractions. This study supports the hypothesis that serum selenium is an integral part of the defence system against degradation products associated with LDL and VLDL in young healthy humans. These associations were not found in diabetes, which might suggest that the defence system against lipid peroxidation is less effective in this disease.
Adolescent↗
IgM against Coxsackie B viruses in children developing type I diabetes mellitus--a seven-year retrospective study.
IgM antibodies to coxsackievirus type B 1-5 (CB 1-5) have recently been observed in sera from children with newly diagnosed insulin-dependent diabetes mellitus (IDDM). In the present study IDDM patients below 15 years of age diagnosed between 1978 and 1984 inclusive in two different areas (counties) of Sweden, Uppsala and Linköping, were studied at the onset of their disease. The incidence of IDDM per 100,000 children below the age of 15 years varied between 11.1 and 40.8, with a mean of 26.3 in Uppsala and 23.0 in Linköping. CB-IgM was determined by a mu-antibody capture radioimmunoassay (RIA) and was found in the sera of 40% (range 15-76%) of the Uppsala patients and 30% (0-57%) of the Linköping patients. The IDDM onset peaked in January, August and October, and these months also displayed the largest numbers of CB-IgM-positive cases. There seemed to be a relation between IDDM incidence and CB-IgM positivity, but not during the whole period. IgM antibodies against CB2 and CB3 predominated during the first part of the study period, whereas during the last two years IgM antibodies against all five serotypes were demonstrated. It is concluded that if CB virus infection is involved in the pathogenesis of IDDM in children, this may be the case in less than half of the patients, though with seasonal and annual peaks and nadirs and also changes of serotypes that may reflect the natural epidemiology of these viruses.
Adolescent↗
Impaired vascular reactivity during the first two years of diabetes mellitus after initial restoration.
Vascular reactivity was studied prospectively in 36 consecutive children (15 males, 21 females) below 15 years from the county of Uppsala with newly acquired type I diabetes mellitus (IDDM). Skin postocclusive hyperaemia was recorded with a transcutaneous oxygen electrode at 37 degrees C on admission before receiving insulin treatment and 1, 6, 12 and 24 months after diagnosis. Fifty-eight healthy children (25 males, 33 females), served as a reference group. The relations between vascular reactivity and age, sex and a number of biochemical variables that are often disturbed in IDDM were analyzed. On admission, the vascular reactivity was significantly lower in diabetic children than in controls (p less than 0.001). This reduction was normalized during the first month of treatment. After two years of diabetes, the vascular reactivity was again significantly lower in diabetic children than in the control group (p less than 0.001). There was no significant correlation between the vascular reactivity, the lag phase or baseline variables and any of the factors mentioned above at any time of investigation, except that serum magnesium was significantly correlated with vascular reactivity after six months of IDDM. It is suggested that the mechanism underlying an impairment of vascular reactivity on admission (reversible) is different from that of the late reduction, which might be a very early manifestation of the later structural diabetic microangiopathy.
Adolescent↗
Recombinant somatropin in treatment of growth hormone deficient children in Sweden and Finland.
A total of 23 previously untreated and 28 previously treated GH deficient children were included for at least 12 months in a trial of recombinant somatropin, 0.1 IU/kg/day given by subcutaneous injection. All the children increased their height velocity over the pretreatment values, to nearly 11 cm/year, corresponding to a significant increase in height of 1 SD score for chronological age. The increase in height SD score for bone age was also statistically significant. No adverse effects were recorded, though one child experienced local itching and redness at the injection site which did not recur after a short cessation of therapy. One child developed detectable antibodies to recombinant somatropin, but the binding capacity was low and no clinical symptoms or growth attenuation occurred. Recombinant somatropin was shown to be safe and effective during the first year of therapy in children with GH deficiency.
Adolescent↗
Matching of host genotype and serotypes of Coxsackie B virus in the development of juvenile diabetes.
Thirty-six consecutive paediatric patients (0-16 years old) with recently contracted juvenile diabetes (IDDM) during 1982-84 were included in the study. Sera were assayed for recent or current Coxsackie B virus (CBV) infection using a specific and sensitive IgM RIA. Eighteen patients (50%) had IgM against CBV 1-5. The patients were also assayed for restriction fragment length polymorphism (RFLP) patterns with DNA probes coding for HLA-DR and DQ beta chains. The CBV-positive patients (n = 18) had either RFLP patterns associated with HLA-DR 3 or 4 or HLA-DQ patterns III or IV beta. Two of the CBV negative patients had neither HLA-DR 3 nor DR 4 and four of them had neither DQ patterns III nor IV. Eleven out of 18 CBV-positive patients had HLA-DQ III and DR 3 (61%) versus 5 out of 18 (28%) of the CBV-negative patients. All 11 patients with serology positive for CBV 2, 3, and 5 had HLA-DR 4 and DQ IV patterns. This was significantly (P less than 0.01) different from all five CBV 4-positive patients, who in contrast all had HLA-DR 3 or HLA-DQ III patterns. CBV 1-positive patients (n = 2) all had HLA-DR 3, 4, and HLA-DQ III, IV patterns. Thus CBV 4 seems to be significantly associated with a different host genetic constitution from at any rate CBV 2, 3, and 5, and possibly CBV 1.
Adolescent↗
Impaired vascular reactivity in newborn infants of smoking mothers.
A transcutaneous PO2 technique was used to study the influence of cigarette smoking during pregnancy on postocclusive reactive hyperaemia of the skin of newborn infants and their mothers. Forty-seven mothers and their infants were studied on two occasions (24-48 and 96-144 h) after birth. Twenty of the mothers were habitual smokers, 27 were non-smokers. All mothers were healthy and their pregnancies and deliveries were normal. The infants were all healthy throughout their first week of life. The mothers had more marked reactive hyperaemia than their newborn infants (p less than 0.001). Infants of smoking mothers had a significantly weaker postischaemic hyperaemic response 24-48 h after birth than infants of nonsmoking mothers (p less than 0.01). This difference had disappeared 96-144 h after birth. Smoking mothers also showed a significantly weaker hyperaemic response to ischaemia than the control mothers at the first investigation (p less than 0.05). This difference was smaller and not statistically significant at the second recording. A decreased capacity for postocclusive reactive hyperaemia might be particularly harmful in asphyctic infants, but it may also be detrimental for a normal postnatal circulatory adaptation.
Blood Gas Monitoring, Transcutaneous↗
[Diagnosis and treatment of fetal congenital adrenal cortex hyperplasia].
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Adrenal Hyperplasia, Congenital↗
[Autoimmune polyendocrinopathies in children].
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Adolescent↗
Arachidonic-acid-induced platelet aggregation is increased in male but not in female smokers.
Arachidonic-acid-induced platelet aggregation was studied in 40 healthy drug-free subjects aged 18-43 years. Aggregation was elicited by lower concentrations of arachidonic acid in smoking men (n = 10) than in non-smoking men (n = 10)(p less than 0.05). No significant difference was found between smoking and nonsmoking females. Adenosine-diphosphate-induced platelet aggregation was not increased in smokers. There was no difference between smokers and non-smokers with respect to mean platelet volume and count within each sex. Females and males differed regarding platelet count in whole blood and platelet sensitivity to arachidonic acid; both differences were secondary to the difference in hematocrit. The parallelism between an increased tendency to aggregation after arachidonic acid stimulation and an increased rate of myocardial infarction in male smokers, and the absence of both these phenomena in female smokers, might be of pathophysiological significance.
Adolescent↗
Growth and somatomedin responses to growth hormone in Down's syndrome.
Five growth retarded children with Down's syndrome, three girls and two boys aged between 3 1/2 and 6 1/2 years with trisomy 21, were treated with human growth hormone for six months. Before treatment the growth hormone response to sleep and insulin-arginine load, as well as serum concentrations of insulin, thyroid hormones, and cortisol was found to be in the normal range. During the treatment with human growth hormone the growth velocity increased in all the children with Down's syndrome from 2.3-2.8 cm to 3.3-5.8 cm per six months. The serum concentrations of immunoreactive insulin like growth factor 1 (IGF-1) were low before treatment and increased during the treatment with human growth hormone. The serum concentrations of immunoreactive insulin like growth factor 2 (IGF-2), which were within the normal range, however, increased during treatment with human growth hormone. Children with Down's syndrome respond to treatment with human growth hormone, with an increase in both growth velocity and serum somatomedin concentrations.
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Maternal smoking reduces prostacyclin formation in human umbilical arteries. A study on strictly selected pregnancies.
Production of prostacyclin (PGI2)-like activity in umbilical arteries in vitro was evaluated in 38 selected newborn infants. Nineteen of the mothers of these infants were habitual smokers and the remaining 19 were non-smokers. To rule out the possibility of disturbing effects of drugs or other factors, the newborn infants and their mothers fulfilled strict criteria regarding normality and control of drug intake. The infants of habitual smokers (greater than 5 cigarettes/day) (n=19) were compared with a control group (n = 19) with non-smoking mothers. Smokers' babies had lower birth weights than the controls (3,500 +/- 440 vs 3,900 +/- 420 g, p less than 0.001). Production of PGI2-like activity was estimated by a bioassay technique. Umbilical arteries of smokers' infants produced significantly less PGI2-like activity (139 +/- 78 ng/g arterial tissue) than those of the controls (201 +/- 87 ng/g) (p less than 0.05). As expected, the two groups differed highly significantly regarding serum levels of markers for exposure to cigarette smoke, but these levels did not correlate to formation of PGI2. Decreased production of PGI2-like activity in umbilical vessels might have an impact on nutritive blood flow and oxygen transport, especially in situations of asphyxia.
Adenosine Diphosphate↗
High frequency of Coxsackie-B-virus-specific IgM in children developing type I diabetes during a period of high diabetes morbidity.
Twenty-four consecutive children with newly diagnosed insulin-dependent (type I) diabetes mellitus (IDDM) were investigated for a history of infectious disease. Thirteen of the 24 (54%) patients reported symptoms of acute infection within two months before diabetes was diagnosed. The mean age was 8.5 years and 15 (63%) of the patients were girls. No clear seasonal variation in onset was seen. Coxsackie B (CB)-virus-specific IgM responses were detected by reverse radioimmunoassay (RIA) in 16 of the 24 (67%) patients on the day of diagnosis of IDDM. The highest titre was usually recorded at that time, but with some the highest titre was found with a second serum obtained three to seven weeks after diagnosis. Thereafter the titres declined, and after six months IgM was detected only in a few patients. Thirteen patients displayed monotypic IgM responses, whereas three patients showed ditypic responses. Among the former, IgM was recorded against Coxsackie B4 (CB4) in four, B5 (CB5) in three, B1 (CB1) in two, B2 (CB2) in two, and B3 (CB3) in two patients. The ditypic responses were against CB2 and CB3, CB3 and CB4, and CB5. No CB-virus-specific IgM was detected in sera, found during the same period, from age-matched nondiabetic children without evidence of infection. In neutralisation (NT) tests, antibodies to the homotypic virus were found in 12 of the 16 diabetic patients showing CB-virus-specific at the time of diagnosis. A significant rise in NT titre was demonstrated in three of these patients. No significant clinical difference was noted between IgM positive and IgM negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Aggregation of and thromboxane B2 synthesis in platelets from newborn infants of smoking and non-smoking mothers.
Cord blood platelet aggregation and thromboxane B2 (TxB2) synthesis were investigated in 20 healthy infants of drug-free healthy mothers with an uncomplicated pregnancy ending at term in a normal vaginal delivery. Eight of the mothers were habitual smokers and the remaining 12 were non-smokers. The platelet count was slightly lower in infants of smoking mothers than in the control infants. There were no differences between the two groups in the qualitative or quantitative aggregation responses (maximal change in optical density) to stimulation by 0.55, 1.1, 3.3 and 6.6 microM adenosine diphosphate, 0.5 and 1.0 mM arachidonic acid (AA) or collagen 1.0 and 5.5 mg/l. Nor was there any difference between the groups in regard to TxB2 synthesis after stimulation by these substances. The amount of TxB2 synthesized merely reflected the occurrence of reversible or irreversible platelet aggregation. Stimulation of platelets by AA induced by far the highest synthesis of TxB2. The generally decreased aggregability of platelets of newborn infants, compared with that in adults, was confirmed in this study. No effect of maternal smoking during pregnancy on the prostaglandin-dependent pathway of aggregation of cord blood platelets was demonstrated.
Adult↗